Transition Probabilities to Dependency, Institutionalization, and Death among the Elderly Over a Decade

Abstract

This article provides data, based on the Massachusetts Health Care Panel Study, on the probabilities that elderly people living in the community make transitions to dependency, institutionalization, or death over a 10-year interval. Assessments of dependency, as classified by Activities of Daily Living (ADLs), are particularly important because they have been proposed as criteria to determine beneficiary eligibility to receive long-term care (LTC) services. After age and gender were controlled, the best predictors of subsequent status were initial ADL status, hospitalization or institutionalization in the year prior to baseline, self-reported health status at baseline, and poverty at baseline. These data can be used as the basis for actuarial estimates for long-term care policies, whether public or private LTC insurance or self-insurance options, such as continuing care retirement communities or life care at home. The uses and implications of these findings are discussed.